Persistent hypoglossal artery--an increased risk for intracranial aneurysms?

A 53-year-old hypertensive female smoker presented with a WFNS grade II subarachnoid haemorrhage. Angiography showed a left persistent hypoglossal artery with multiple intracranial aneurysms. She underwent successful coil embolisation of the ruptured aneurysm. We reviewed the literature on persistent hypoglossal artery and found 26% of them have associated intracranial aneurysms. This controversial topic is discussed.